中国布加综合征和非肝硬化门静脉血栓形成患者促凝血与抗凝血因子失衡
Imbalance of pro- vs. anti-coagulation factors in Chinese patients with Budd-Chiari syndrome and non-cirrhotic portal vein thrombosis.
作者信息
Chen Hui, Liu Lei, Qi Xingshun, He Chuangye, Yin Zhanxin, Wu Feifei, Fan Daiming, Han Guohong
机构信息
Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
出版信息
PLoS One. 2015 Mar 30;10(3):e0119909. doi: 10.1371/journal.pone.0119909. eCollection 2015.
BACKGROUND AND AIM
The coagulation abnormalities in non-cirrhotic Budd-Chiari syndrome (NC-BCS) and non-cirrhotic portal vein thrombosis (NC-PVT) are unclear. We conducted this case-control study to investigate the coagulation profile of NC-BCS and NC-PVT in Chinese patients.
METHODS
We measured the levels of factors II, V, VII, VIII, IX, X, XI, XII, protein C (PC), protein S (PS) and antithrombin (AT) in blood samples from 37 NC-BCS patients, 74 NC-PVT patients, and 100 healthy controls. The levels and ratios of pro- and anti-coagulation factors were compared between patients with NC-BCS and healthy controls, between different types of NC-BCS and between NC-PVT and healthy controls.
RESULTS
In patients with NC-BCS, factor VIII (P<0.001) was significantly elevated; factor V (P<0.001), VII (P<0.001), IX (P = 0.003), X (P<0.001), XI (P<0.001), XII (P<0.001), PC (P<0.001) and AT (P<0.001) were significantly decreased; and no difference was observed for factor II (P = 0.088) and PS (P = 0.199) compared with healthy controls. Factor VIII-to-PC (P = 0.008), factor VIII-to-PS (P = 0.037) and factor VIII-to-AT (P = 0.001) were significantly increased; other ratios were significantly reduced or did not show any difference. No differences were observed between different types of NC-BCS for individual pro- and anti-coagulation factors or the ratios between them. Among patients with NC-PVT, factor VIII (P<0.001) was significantly elevated and other factors were significantly decreased. Factor II-to-PC (P<0.001), factor VIII-to-PC (P<0.001), factor IX-to-PC (P<0.001), factor VIII-to-PS (P<0.001), factor II-to-AT (P<0.001), factor VIII-to-AT (P<0.001) and factor IX-to-AT (P<0.001) were significantly increased; all other ratios for NC-PVT were significantly reduced or did not show any significant difference.
CONCLUSIONS
NC-BCS and NC-PVT are associated with elevated levels of factor VIII and the decreased levels of PC and AT were probably the most significant features of coagulation imbalance. Additionally, NC-PVT was associated with decreased levels of PS.
背景与目的
非肝硬化性布加综合征（NC-BCS）和非肝硬化性门静脉血栓形成（NC-PVT）中的凝血异常尚不清楚。我们开展了这项病例对照研究，以调查中国患者中NC-BCS和NC-PVT的凝血谱。
方法
我们检测了37例NC-BCS患者、74例NC-PVT患者和100例健康对照者血样中凝血因子II、V、VII、VIII、IX、X、XI、XII、蛋白C（PC）、蛋白S（PS）和抗凝血酶（AT）的水平。比较了NC-BCS患者与健康对照者之间、不同类型的NC-BCS之间以及NC-PVT患者与健康对照者之间促凝血因子和抗凝血因子的水平及比率。
结果
在NC-BCS患者中，凝血因子VIII（P<0.001）显著升高；凝血因子V（P<0.001）、VII（P<0.001）、IX（P = 0.003）、X（P<0.001）、XI（P<0.001）、XII（P<0.001）、PC（P<0.001）和AT（P<0.001）显著降低；与健康对照者相比，凝血因子II（P = 0.088）和PS（P = 0.199）无差异。凝血因子VIII与PC的比值（P = 0.008）、凝血因子VIII与PS的比值（P = 0.037）和凝血因子VIII与AT的比值（P = 0.001）显著升高；其他比值显著降低或无差异。不同类型的NC-BCS之间，单个促凝血因子和抗凝血因子或它们之间的比值无差异。在NC-PVT患者中，凝血因子VIII（P<0.0）显著升高，其他因子显著降低。凝血因子II与PC的比值（P<0.001）、凝血因子VIII与PC的比值（P<0.001）、凝血因子IX与PC的比值（P<0.001）、凝血因子VIII与PS的比值（P<0.001）、凝血因子II与AT的比值（P<0.001）、凝血因子VIII与AT的比值（P<0.001）和凝血因子IX与AT的比值（P<0.001）显著升高；NC-PVT的所有其他比值显著降低或无显著差异。
结论
NC-BCS和NC-PVT与凝血因子VIII水平升高有关，PC和AT水平降低可能是凝血失衡的最显著特征。此外，NC-PVT与PS水平降低有关。
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